| ABSTRACT Objective: To investigate the value of transthoracic echocardiography (TTE) and transthoracic right heart contrast echocardiography (c-TTE) in the diagnosis of migraine and right-to-left shunt (RLS) caused by patent foramen ovale (PFO). Methods: 82 patients with suspected PFO-induced migraine were selected, all patients underwent TTE and c-TTE examinations, the result of digital subtraction angiography (DSA) was used as the gold standard, the consistency of TTE, c-TTE and DSA results was tested by Kappa coefficient, the efficacy of TTE and c-TTE in the diagnosis of PFO-induced migraine and RLS was analyzed by four-grid table method and receiver operating characteristic(ROC) curve. Results: Among the 82 migraine patients, 60 cases of PFO were diagnosed by DSA. TTE detected a total of 42 cases of PFO, which was generally consistent with the diagnostic results of DSA (Kappa=0.294, P<0.05). c-TTE detected a total of 57 cases of PFO, which was highly consistent with the results of DSA (Kappa=0.879, P<0.05). TTE detected a total of 36 cases of RLS, which was generally consistent with the diagnostic results of DSA(Kappa=0.260, P<0.05). c-TTE detected a total of 53 cases of RLS, which was consistent with the results of DSA (Kappa=0.706, P<0.05). Compared with TTE, c-TTE diagnosed PFO with higher sensitivity, specificity, accuracy, positive predictive value and negative predictive value (Z=4.889, P<0.05). Compared with TTE, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of c-TTE in diagnosing RLS were higher (Z=4.412, P<0.05). Conclusion: Relative to TTE, c-TTE can diagnose PFO and RLS classification more sensitively and accurately, and has higher diagnostic value in patients with migraine due to PFO. |
